Your bones become more fragile as you age, increasing the likelihood of a fracture, especially if you have osteoporosis. Many patients don’t know they have osteoporosis because there are no symptoms.

Falls are the leading cause of bone fractures and injury deaths in older adults. Preventing falls before they occur is one of the best ways to avoid injuries and protect fragile bones.

Here’s how to create a fall-prevention game plan:

1. Make an appointment with your doctor. Make sure to bring a list of your prescriptions. Together, you and your doctor can review any side effects such as dizziness that could cause a fall. Mention any previous falls – no matter how minimal – and if you have experienced symptoms such as changes in vision or walking gait.
2. Get moving. Wear low-heeled, comfortable shoes that fit properly when exercising or walking outdoors. Work on strength training and exercises that integrate flexibility, agility, coordination and balance. Focus on alignment, especially within areas of the ankle, knee, hip and trunk, which can improve posture, rotation and stable movement.
3. Change up your living space. Making small adjustments to your home can prevent falls before they occur. Add lamps in dim areas or position a flashlight with a magnet on the fridge. Place a non-slip rubber mat in your bathtub or shower, remove small rugs from traffic areas, and move frequently-used items within reach. Clear clutter by organizing shoes, books and decorative items in containers away from walking areas.

If you do fall and are at risk for osteoporosis, it’s important to let your doctor know right away especially if there is any pain or swelling.

Medicare Part B covers a bone density test once every 24 months, or every two years, for all qualified people with Part B and who are at risk for osteoporosis. A bone density test measures how strong your bones are. The lower your bone density, the higher your risk is for a fracture.

There are some risk factors that you can control and others you cannot. NIH Senior Health provides a checklist to help determine your risk.

Risk factors you cannot influence include age, being a female, especially Caucasian or Asian; a family history of osteoporosis, or having a history of previous fracture.

Risk factors you can influence include getting adequate calcium and Vitamin D intake, regular physical activity, not smoking and maintaining a healthy body weight.

Kelly Brammer, who wrote this article, is a registered nurse and supervisor of the Care Advantage Program for The Polyclinic in Seattle.